Gamba J L, Woodruff W W, Djang W T, Yeates A E
Radiology. 1986 Jul;160(1):207-12. doi: 10.1148/radiology.160.1.3715034.
Computed tomographic (CT) scans of ten patients with rhinocerebral mucormycosis were reviewed. Early paranasal sinus involvement appeared as mucosal thickening on CT scans, usually without air/fluid levels. Recognition as mucormycosis was facilitated by knowledge of the clinical setting or by identification of invasive disease. Evidence of bone destruction on CT scans was seen in only two patients, was a late finding, and usually was absent despite deep extension of disease beyond the bony confines of the paranasal sinus. Five cases had intracranial involvement, either as fungal abscess or infarction. Intracranial mucormycosis usually involved the base of the brain and cerebellum following invasion of the infratemporal fossa or orbit. Intracerebral fungal abscess appeared as low-density masses on CT scans, with variable peripheral enhancement and little surrounding vasogenic edema. Identification of a rim of spared cortex was useful in distinguishing infection from bland infarct. Serial CT scans were also useful in assessing response to hyperbaric oxygen treatment, surgery, and chemotherapy.
回顾了10例鼻脑型毛霉菌病患者的计算机断层扫描（CT）图像。早期鼻窦受累在CT扫描上表现为黏膜增厚，通常无气液平面。结合临床情况或识别侵袭性疾病有助于诊断为毛霉菌病。仅2例患者在CT扫描上可见骨质破坏，这是晚期表现，尽管疾病已深入鼻窦骨边界之外，但通常仍无骨质破坏。5例患者有颅内受累，表现为真菌性脓肿或梗死。颅内毛霉菌病通常在颞下窝或眼眶受侵后累及脑底部和小脑。脑内真菌性脓肿在CT扫描上表现为低密度肿块，周边强化程度不一，周围血管源性水肿较轻。识别一圈未受累的皮质有助于将感染与单纯性梗死区分开来。系列CT扫描也有助于评估对高压氧治疗、手术和化疗的反应。
